The Association of Prediabetes and Diabetes Risk Perception With Leisure-Time Physical Activity and Weight Loss

Purpose: To examine the association of perceived risk of prediabetes and diabetes with leisure-time physical activity (LTPA) and weight loss, and determine whether the association of risk perception with LTPA and weight loss varies by race/ethnicity. Design: Cross-sectional. Setting: National Health and Nutrition Examination Survey (NHANES) 2011-2014. Subjects: Non-Latino white, non-Latino black, and Latino nondiabetic and nonprediabetic NHANES participants ≥18 years of age who were not underweight (n = 9550). Measures: Demographic characteristics, LTPA, attempted weight loss, and perceived risk of prediabetes or diabetes. Analysis: Log-binomial regression models were fit to assess the association of perceived risk with meeting LTPA recommendations and having attempted to lose weight, overall and by race/ethnicity. Results: Individuals reporting that they perceived they could be at risk for diabetes/prediabetes were less likely to meet LTPA recommendations (adjusted prevalence ratio [aPR]: 0.87; 95% confidence interval [CI]: 0.79-0.95), but significantly more likely to report attempting weight loss in the past year (aPR: 1.14; 95%CI: 1.04-1.25), compared with those reporting no risk perception. Latino and non-Latino blacks who perceived they could be at risk for diabetes/prediabetes were 25% and 35% more likely to report trying to lose weight in the past year (aPR: 1.25; 95% CI: 1.08-1.44 and aPR: 1.35; 95% CI: 1.19-1.54, respectively), compared with Latino and non-Latino blacks that did not perceive being at risk. In contrast, non-Latino whites who perceived they were at risk were 20% less likely to report meeting LTPA recommendations (aPR: 0.80; 95% CI: 0.72-0.89), compared with non-Latino whites reporting no risk perception. Conclusion: Findings highlight the role of perceived risk for prediabetes and diabetes in LTPA and weight loss, with findings varying by race/ethnicity. Awareness of prediabetes and diabetes risk could contribute to efforts aimed at improving LTPA and weight loss.